TREATMENT OF THE HYPERMETABOLIC RESPONSE TO CNS INJURY

本研究的目的是改善神经病学的结果， 通过提供最佳的全身环境， 受伤的大脑神经损伤会导致全身异常， 对神经恢复有不良影响。代谢亢进可以 迅速导致蛋白质-热量营养不良， 免疫功能不全，多器官衰竭，和延迟愈合的 损伤由于全身性应激反应，高血压可能会恶化 受伤大脑乳酸酸中毒的严重程度。 拟议项目的第一个具体目标是开发一种方法， 为神经损伤患者提供营养， 和系统性蛋白质和能量需求， 高血糖症一项临床试验将评估三醋精的使用， 1，3-丁二醇作为脑损伤患者的非蛋白质热量来源。 喂养对大脑和全身代谢的影响将 被评价。 第二个具体目标是确定这些代谢和 生理疗法将改善严重脑损伤后的死亡率。 第三个具体目标是研究系统的关系， 高代谢对CNS炎症反应神经损伤的影响。 这些研究将与以下临床试验联合进行： 抗炎药氯喹和秋水仙碱，如 详细项目4

The objective of this research is to improve outcome from a nuerological injury by providing the optimal systemic environment for recovery of the injured brain. Neurological injury causes systemic abnormalities that may have adverse effects on neurological recovery. Hypermetabolism can rapidly result in protein-calorie malnutrition, causing immunoincompetence, multi-organ failure, and delayed healing of the injury. Hyperglycemia, due to the systemic stress response, may worsen the severity of lactic acidosis of the injured brain. The first specific aim of the proposed project is to develop a method of alimenting neurologically injured patients which will satisfy cerebral and systemic protein and energy requirements without producing hyperglycemia. A clinical trial will evaluate the use of triacetin and 1,3-butanediol as nonprotein caloric sources in head injured patients. The effects of the feedings on both cerebral and systemic metabolism will be evaluated. The second specific aim is to determine if these metabolic and physiological therapies will improve mortality after severe head injury. The tird specific aim is to study the relationship of the systemic hypermetabolism to the CNS inflammatory response to neurological injury. These studies will be performed in association with a clinical trial of the anti-inflammatory drugs, chloroquine and colchicine, as described in detail in Project 4.